| NPI | 1386099786 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.144339) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 59984) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2024-07-22 |